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Left upper lobectomy is a risk factor for cerebral infarction after pulmonary resection: a multicentre, retrospective, case–control study in Japan

A Correction to this article was published on 03 September 2020

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The anatomical site of resected lobes may influence postoperative cerebral infarction. The objective of the current study was to determine if left upper pulmonary lobectomy is a risk factor for postoperative cerebral infarction.


This was a retrospective case–control study in patients undergoing pulmonary lobectomy from 2004 to 2013 in Japan. We retrospectively identified 610 patients from 153 institutions who had developed postoperative cerebral infarction following pulmonary lobectomy. The control group consisted of 773 patients who underwent lobectomy without cerebral infarction during a randomly selected single month in 2009 at the same institutions.


Factors associated with cerebral infarction were age [10-year intervals, odds ratio (OR): 1.46; 95% confidence interval (CI): 1.23–1.73; p < 0.001], male sex (OR 1.92; 95% CI 1.29–2.86; p = 0.001), presence of comorbidities (OR 1.82; 95% CI 1.35–2.44; p < 0.001), perioperative anti-platelet or anti-coagulant drug use (OR 1.71; 95% CI 1.20–2.45; p = 0.003), and lobectomy. Subgroup analyses revealed that cerebral infarction was strongly associated with left upper lobectomy.


Our findings suggest that left upper lobectomy is associated with a higher risk of cerebral infarction than other types of lobectomy, particularly in the early postoperative period.

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  • 03 September 2020

    The original article can be found online.


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The authors are grateful to the members of the JACS office for their support with data management and to the members of each JACS institute included in this study for their assistance with data collection.



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Correspondence to Nagayasu Takeshi.

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Matsumoto, K., Sato, S., Okumura, M. et al. Left upper lobectomy is a risk factor for cerebral infarction after pulmonary resection: a multicentre, retrospective, case–control study in Japan. Surg Today 50, 1383–1392 (2020).

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